Hematocrit levels and hospitalization risks in hemodialysis patients

The association between hematocrit level and future hospitalization risks i n hemodialysis patients has not been fully investigated on a national level . A total of 71,717 prevalent Medicare hemodialysis patients who survived a 6-mo entry period from July 1 through December 31, 1993 were studied, and their risk of hospitalizations was evaluated the next year. Five hematocrit groups were defined from Medicare recombinant human erythropoietin-treated patients: <27%, 27 to <30%, 30 to <33%, 33 to <36%, and greater than or eq ual to 36%. A Cox regression model was used to investigate the association between hematocrit level and the risk of first hospitalization, and the And ersen-Gill regression model evaluated multiple hospitalizations during the next year, adjusting for patient comorbidity and severity of disease. Compa red with the baseline group of 30 to <33%, patients with hematocrit levels <30% had a 14 to 30% increased risk of hospitalization without disease seve rity adjustment (p = 0.0001) and a 7 to 18% increased risk with disease sev erity adjustment (p = 0.0001). Patients in the 33 to <36% group had the low est risk at 0.93 and 0.88 (p = 0.0001), with and without adjustment for dis ease severity. It is concluded that patients with hematocrits of <30% have an increased risk of future hospitalization, with hematocrit levels between 33 and 36% having the lowest associated risks.